HL7 Europe Hospital Discharge Report
1.0.0-alpha - qa-preview 150

HL7 Europe Hospital Discharge Report, published by HL7 Europe. This guide is not an authorized publication; it is the continuous build for version 1.0.0-alpha built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/hl7-eu/hdr/ and changes regularly. See the Directory of published versions

## Resource Profile: MedicationRequest: obligations

Official URL: http://hl7.eu/fhir/hdr/StructureDefinition/medicationRequest-obl-eu-hdr | Version: 1.0.0-alpha
Standards status: Informative | Maturity Level: 0 | Computable Name: MedicationRequestEuHdrObligation
Copyright/Legal: Copyright HL7 Europe. Licensed under creative commons public domain (CC0 1.0).

This profile defines obligations for the MedicationRequest resource for the purpose of this guide, adapted from the MPD work.

Usages:

- This Profile is not used by any profiles in this Implementation Guide

You can also check for usages in the FHIR IG Statistics

### Formal Views of Profile Content

Description of Profiles, Differentials, Snapshots and how the different presentations work.

- Key Elements Table
- Differential Table
- Snapshot Table
- Statistics/References
- All

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequestEuHdr | Ordering of medication for patient or group
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
extension:effectiveDosePeriod |  | 0..1 | Period | Period over which the medication should be taken. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.effectiveDosePeriod Constraints: ext-1
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!O Σ | 1..1 | code | Current state of the order Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
Obligations | Actor
SHALL:handle | HDRConsumer
SHOULD:able-to-populate | HDRCreator
intent | ?!Σ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action
medication[x] | O Σ | 1..1 |  | Medication to be taken Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
Obligations | Actor
SHALL:handle | HDRConsumer
SHOULD:able-to-populate | HDRCreator
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication (HDR)) |
subject | O Σ | 1..1 | Reference(Patient (EU core)) | Who or group medication request is for
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
authoredOn | O Σ | 1..1 | dateTime | When request was initially authored
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
requester | O Σ | 1..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) | Who/What requested the Request
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
reasonCode | O | 0..* | CodeableConcept | Reason or indication for this prescription Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
Obligations | Actor
SHALL:handle | HDRConsumer
MAY:able-to-populate | HDRCreator
reasonReference | O | 0..* | Reference(Condition | Observation) | Condition or observation that supports this prescription
Obligations | Actor
SHALL:handle | HDRConsumer
MAY:able-to-populate | HDRCreator
groupIdentifier | O Σ | 0..1 | Identifier | Prescription this is part of. Not needed if a presciption includes only one prescribed item.
Obligations | Actor
SHALL:handle | HDRConsumer
MAY:able-to-populate | HDRCreator
dosageInstruction | O | 0..* | Dosage | How the medication should be taken.
Obligations | Actor
SHALL:handle | HDRConsumer
MAY:able-to-populate | HDRCreator
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
text | O Σ | 0..1 | string | Free text dosage instructions
Obligations | Actor
SHALL:handle | HDRConsumer
SHOULD:able-to-populate | HDRCreator
timing | O Σ | 0..1 | Timing | Administration schedule
Obligations | Actor
SHALL:handle | HDRConsumer
SHOULD:able-to-populate | HDRCreator
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
dispenseRequest | O | 0..1 | BackboneElement | Medication supply authorization
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
Slices for extension |  |  |  | Content/Rules for all slices
extension:prescribedQuantity |  | 0..1 | Quantity | Overall amount of product prescribed, independent from the number of repeats. URL: https://profiles.ihe.net/PHARM/MPD/StructureDefinition/ihe-ext-medicationrequest-prescribedQuantity
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
quantity | O | 0..1 | SimpleQuantity(4.0.1) | Amount of medication to supply per dispense
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.status | Base | required | Medicationrequest status | 📍4.0.1 | FHIR Std.
MedicationRequest.intent | Base | required | Medication request intent | 📍4.0.1 | FHIR Std.
MedicationRequest.medication[x] | Base | example | SNOMED CT Medication Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.reasonCode | Base | example | Condition/Problem/Diagnosis Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | MedicationRequest.extension:effectiveDosePeriod, MedicationRequest.modifierExtension, MedicationRequest.dosageInstruction.modifierExtension, MedicationRequest.dosageInstruction.timing.modifierExtension, MedicationRequest.dispenseRequest.extension:prescribedQuantity, MedicationRequest.dispenseRequest.modifierExtension | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

This structure is derived from MedicationRequestEuHdr

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequestEuHdr | Ordering of medication for patient or group
status | O | 1..1 | code | Current state of the order
Obligations | Actor
SHALL:handle | HDRConsumer
SHOULD:able-to-populate | HDRCreator
medication[x] | O | 1..1 | CodeableConcept, Reference(Medication (HDR)) | Medication to be taken
Obligations | Actor
SHALL:handle | HDRConsumer
SHOULD:able-to-populate | HDRCreator
subject | O | 1..1 | Reference(Patient (EU core)) | Who or group medication request is for
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
authoredOn | O | 1..1 | dateTime | When request was initially authored
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
requester | O | 1..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) | Who/What requested the Request
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
reasonCode | O | 0..* | CodeableConcept | Reason or indication for this prescription
Obligations | Actor
SHALL:handle | HDRConsumer
MAY:able-to-populate | HDRCreator
reasonReference | O | 0..* | Reference(Condition | Observation) | Condition or observation that supports this prescription
Obligations | Actor
SHALL:handle | HDRConsumer
MAY:able-to-populate | HDRCreator
groupIdentifier | O | 0..1 | Identifier | Prescription this is part of. Not needed if a presciption includes only one prescribed item.
Obligations | Actor
SHALL:handle | HDRConsumer
MAY:able-to-populate | HDRCreator
dosageInstruction | O | 0..* | Dosage | How the medication should be taken.
Obligations | Actor
SHALL:handle | HDRConsumer
MAY:able-to-populate | HDRCreator
text | O | 0..1 | string | Free text dosage instructions
Obligations | Actor
SHALL:handle | HDRConsumer
SHOULD:able-to-populate | HDRCreator
timing | O | 0..1 | Timing | Administration schedule
Obligations | Actor
SHALL:handle | HDRConsumer
SHOULD:able-to-populate | HDRCreator
doseAndRate |  |  |  |
Slices for dose[x] |  |  |  | Content/Rules for all slices
dose[x]:doseQuantity | O | 0..1 | SimpleQuantity | Amount of medication per dose
Obligations | Actor
SHALL:handle | HDRConsumer
SHOULD:able-to-populate | HDRCreator
dispenseRequest | O | 0..1 | BackboneElement | Medication supply authorization
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
quantity | O | 0..1 | SimpleQuantity(4.0.1) | Amount of medication to supply per dispense
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
substitution |  |  |  |
Slices for allowed[x] |  | 1..1 | boolean, CodeableConcept | Whether substitution is allowed or not Slice: Unordered, Open by type:$this
allowed[x]:allowedCodeableConcept | O | 0..1 | CodeableConcept | Whether substitution is allowed or not
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
Documentation for this format

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequestEuHdr | Ordering of medication for patient or group
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:effectiveDosePeriod |  | 0..1 | Period | Period over which the medication should be taken. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.effectiveDosePeriod Constraints: ext-1
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | Prescription/prescribed item ID
status | ?!O Σ | 1..1 | code | Current state of the order Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
Obligations | Actor
SHALL:handle | HDRConsumer
SHOULD:able-to-populate | HDRCreator
statusReason |  | 0..1 | CodeableConcept | Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent | ?!Σ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
category |  | 0..* | CodeableConcept | Type of medication usage Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action
reported[x] | Σ | 0..1 |  | Reported rather than primary record
reportedBoolean |  |  | boolean |
reportedReference |  |  | Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) |
medication[x] | O Σ | 1..1 |  | Medication to be taken Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
Obligations | Actor
SHALL:handle | HDRConsumer
SHOULD:able-to-populate | HDRCreator
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication (HDR)) |
subject | O Σ | 1..1 | Reference(Patient (EU core)) | Who or group medication request is for
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
encounter |  | 0..1 | Reference(Encounter) | Encounter created as part of encounter/admission/stay
supportingInformation |  | 0..* | Reference(Resource) | Information to support ordering of the medication
authoredOn | O Σ | 1..1 | dateTime | When request was initially authored
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
requester | O Σ | 1..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) | Who/What requested the Request
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
performer |  | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) | Intended performer of administration
performerType | Σ | 0..1 | CodeableConcept | Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.
recorder |  | 0..1 | Reference(Practitioner | PractitionerRole) | Person who entered the request
reasonCode | O | 0..* | CodeableConcept | Reason or indication for this prescription Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
Obligations | Actor
SHALL:handle | HDRConsumer
MAY:able-to-populate | HDRCreator
reasonReference | O | 0..* | Reference(Condition | Observation) | Condition or observation that supports this prescription
Obligations | Actor
SHALL:handle | HDRConsumer
MAY:able-to-populate | HDRCreator
instantiatesCanonical | Σ | 0..* | canonical() | Instantiates FHIR protocol or definition
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition
basedOn | Σ | 0..* | Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) | What request fulfills
groupIdentifier | O Σ | 0..1 | Identifier | Prescription this is part of. Not needed if a presciption includes only one prescribed item.
Obligations | Actor
SHALL:handle | HDRConsumer
MAY:able-to-populate | HDRCreator
courseOfTherapyType |  | 0..1 | CodeableConcept | Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
insurance |  | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage
note |  | 0..* | Annotation | Information about the prescription
dosageInstruction | O | 0..* | Dosage | How the medication should be taken.
Obligations | Actor
SHALL:handle | HDRConsumer
MAY:able-to-populate | HDRCreator
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
sequence | Σ | 0..1 | integer | The order of the dosage instructions
text | O Σ | 0..1 | string | Free text dosage instructions
Obligations | Actor
SHALL:handle | HDRConsumer
SHOULD:able-to-populate | HDRCreator
additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction | Σ | 0..1 | string | Patient or consumer oriented instructions
timing | O Σ | 0..1 | Timing | Administration schedule
Obligations | Actor
SHALL:handle | HDRConsumer
SHOULD:able-to-populate | HDRCreator
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
event | Σ | 0..* | dateTime | When the event occurs
repeat | Σ C | 0..1 | Element | When the event is to occur Constraints: tim-1, tim-2, tim-4, tim-5, tim-6, tim-7, tim-8, tim-9, tim-10
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
bounds[x] | Σ | 0..1 |  | Length/Range of lengths, or (Start and/or end) limits
boundsDuration |  |  | Duration |
boundsRange |  |  | Range |
boundsPeriod |  |  | Period |
count | Σ | 0..1 | positiveInt | Number of times to repeat
countMax | Σ | 0..1 | positiveInt | Maximum number of times to repeat
duration | Σ | 0..1 | decimal | Duration of the treatment
durationMax | Σ | 0..1 | decimal | How long when it happens (Max)
durationUnit | Σ | 0..1 | code | s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM).
frequency | Σ | 0..1 | positiveInt | Frequency times per period
frequencyMax | Σ | 0..1 | positiveInt | Event occurs up to frequencyMax times per period
period | Σ | 0..1 | decimal | Duration of time over which repetitions are to occur
periodMax | Σ | 0..1 | decimal | Upper limit of period (3-4 hours)
periodUnit | Σ | 0..1 | code | Unit of the period (e.g. day) Binding: UnitsOfTime (required): A unit of time (units from UCUM).
dayOfWeek | Σ | 0..* | code | mon | tue | wed | thu | fri | sat | sun Binding: DaysOfWeek (required)
timeOfDay | Σ | 0..* | time | Time of day for action
when | Σ | 0..* | code | Code for time period of occurrence Binding: EventTiming (required): Real world event relating to the schedule.
offset | Σ | 0..1 | unsignedInt | Minutes from event (before or after)
code | Σ | 0..1 | CodeableConcept | A code for the timing schedule. Binding: TimingAbbreviation (preferred): Code for a known / defined timing pattern.
asNeeded[x] | Σ | 0..1 |  | Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean |  |  | boolean |
asNeededCodeableConcept |  |  | CodeableConcept |
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route | Σ | 0..1 | CodeableConcept | Route of administration Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate | Σ | 0..* | Element | Amount of medication administered
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
type | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
Slices for dose[x] | Σ | 0..1 |  | Amount of medication per dose Slice: Unordered, Closed by type:$this
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
dose[x]:doseQuantity | O Σ | 0..1 | SimpleQuantity | Amount of medication per dose
Obligations | Actor
SHALL:handle | HDRConsumer
SHOULD:able-to-populate | HDRCreator
rate[x] | Σ | 0..1 |  | Amount of medication per unit of time
rateRatio |  |  | Ratio |
rateRange |  |  | Range |
rateQuantity |  |  | Quantity(SimpleQuantity) |
maxDosePerPeriod | Σ | 0..1 | Ratio | Upper limit on medication per unit of time
maxDosePerAdministration | Σ | 0..1 | SimpleQuantity(4.0.1) | Upper limit on medication per administration
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity(4.0.1) | Upper limit on medication per lifetime of the patient
dispenseRequest | O | 0..1 | BackboneElement | Medication supply authorization
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:prescribedQuantity |  | 0..1 | Quantity | Overall amount of product prescribed, independent from the number of repeats. URL: https://profiles.ihe.net/PHARM/MPD/StructureDefinition/ihe-ext-medicationrequest-prescribedQuantity
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
initialFill |  | 0..1 | BackboneElement | First fill details
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
quantity |  | 0..1 | SimpleQuantity(4.0.1) | First fill quantity
duration |  | 0..1 | Duration | First fill duration
dispenseInterval |  | 0..1 | Duration | Minimum period of time between dispenses
validityPeriod |  | 0..1 | Period | Time period supply is authorized for
numberOfRepeatsAllowed |  | 0..1 | unsignedInt | Number of refills authorized
quantity | O | 0..1 | SimpleQuantity(4.0.1) | Amount of medication to supply per dispense
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
expectedSupplyDuration |  | 0..1 | Duration | Number of days supply per dispense
performer |  | 0..1 | Reference(Organization) | Intended dispenser
substitution |  | 0..1 | BackboneElement | Any restrictions on medication substitution
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
Slices for allowed[x] |  | 1..1 |  | Whether substitution is allowed or not Slice: Unordered, Open by type:$this Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
allowedBoolean |  |  | boolean |
allowedCodeableConcept |  |  | CodeableConcept |
allowed[x]:allowedCodeableConcept | O | 0..1 | CodeableConcept | Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
reason |  | 0..1 | CodeableConcept | Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
priorPrescription |  | 0..1 | Reference(MedicationRequest) | An order/prescription that is being replaced
detectedIssue |  | 0..* | Reference(DetectedIssue) | Clinical Issue with action
eventHistory |  | 0..* | Reference(Provenance) | A list of events of interest in the lifecycle
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
MedicationRequest.status | Base | required | Medicationrequest status | 📍4.0.1 | FHIR Std.
MedicationRequest.statusReason | Base | example | Medication request status reason codes | 📍4.0.1 | FHIR Std.
MedicationRequest.intent | Base | required | Medication request intent | 📍4.0.1 | FHIR Std.
MedicationRequest.category | Base | example | Medication request category codes | 📍4.0.1 | FHIR Std.
MedicationRequest.priority | Base | required | Request priority | 📍4.0.1 | FHIR Std.
MedicationRequest.medication[x] | Base | example | SNOMED CT Medication Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.performerType | Base | example | Procedure Performer Role Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.reasonCode | Base | example | Condition/Problem/Diagnosis Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.courseOfTherapyType | Base | example | Medication request course of therapy codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​additionalInstruction | Base | example | SNOMED CT Additional Dosage Instructions | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​timing.repeat.durationUnit | Base | required | UnitsOfTime | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​timing.repeat.periodUnit | Base | required | UnitsOfTime | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​timing.repeat.dayOfWeek | Base | required | DaysOfWeek | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​timing.repeat.when | Base | required | EventTiming | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​timing.code | Base | preferred | TimingAbbreviation | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​site | Base | example | SNOMED CT Anatomical Structure for Administration Site Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​route | Base | example | SNOMED CT Route Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​method | Base | example | SNOMED CT Administration Method Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​doseAndRate.type | Base | example | DoseAndRateType | 📍4.0.1 | FHIR Std.
MedicationRequest.substitution.​allowed[x] | Base | example | ActSubstanceAdminSubstitutionCode | 📦3.0.0 | THO v7.1
MedicationRequest.substitution.​allowed[x]:allowedCodeableConcept | Base | example | ActSubstanceAdminSubstitutionCode | 📦3.0.0 | THO v7.1
MedicationRequest.substitution.​reason | Base | example | SubstanceAdminSubstitutionReason | 📦3.0.0 | THO v7.1

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
tim-1 | error | MedicationRequest.dosageInstruction.timing.repeat | if there's a duration, there needs to be duration units | `duration.empty() or durationUnit.exists()`
tim-2 | error | MedicationRequest.dosageInstruction.timing.repeat | if there's a period, there needs to be period units | `period.empty() or periodUnit.exists()`
tim-4 | error | MedicationRequest.dosageInstruction.timing.repeat | duration SHALL be a non-negative value | `duration.exists() implies duration >= 0`
tim-5 | error | MedicationRequest.dosageInstruction.timing.repeat | period SHALL be a non-negative value | `period.exists() implies period >= 0`
tim-6 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a periodMax, there must be a period | `periodMax.empty() or period.exists()`
tim-7 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a durationMax, there must be a duration | `durationMax.empty() or duration.exists()`
tim-8 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a countMax, there must be a count | `countMax.empty() or count.exists()`
tim-9 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's an offset, there must be a when (and not C, CM, CD, CV) | `offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))`
tim-10 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a timeOfDay, there cannot be a when, or vice versa | `timeOfDay.empty() or when.empty()`

This structure is derived from MedicationRequestEuHdr

Summary

Structures

This structure refers to these other structures:

- SimpleQuantity (http://hl7.org/fhir/StructureDefinition/SimpleQuantity)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of MedicationRequest.substitution.allowed[x]

Maturity: 0

Key Elements View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequestEuHdr | Ordering of medication for patient or group
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
Slices for extension |  |  |  | Content/Rules for all slices
extension:effectiveDosePeriod |  | 0..1 | Period | Period over which the medication should be taken. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.effectiveDosePeriod Constraints: ext-1
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
status | ?!O Σ | 1..1 | code | Current state of the order Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
Obligations | Actor
SHALL:handle | HDRConsumer
SHOULD:able-to-populate | HDRCreator
intent | ?!Σ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action
medication[x] | O Σ | 1..1 |  | Medication to be taken Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
Obligations | Actor
SHALL:handle | HDRConsumer
SHOULD:able-to-populate | HDRCreator
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication (HDR)) |
subject | O Σ | 1..1 | Reference(Patient (EU core)) | Who or group medication request is for
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
authoredOn | O Σ | 1..1 | dateTime | When request was initially authored
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
requester | O Σ | 1..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) | Who/What requested the Request
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
reasonCode | O | 0..* | CodeableConcept | Reason or indication for this prescription Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
Obligations | Actor
SHALL:handle | HDRConsumer
MAY:able-to-populate | HDRCreator
reasonReference | O | 0..* | Reference(Condition | Observation) | Condition or observation that supports this prescription
Obligations | Actor
SHALL:handle | HDRConsumer
MAY:able-to-populate | HDRCreator
groupIdentifier | O Σ | 0..1 | Identifier | Prescription this is part of. Not needed if a presciption includes only one prescribed item.
Obligations | Actor
SHALL:handle | HDRConsumer
MAY:able-to-populate | HDRCreator
dosageInstruction | O | 0..* | Dosage | How the medication should be taken.
Obligations | Actor
SHALL:handle | HDRConsumer
MAY:able-to-populate | HDRCreator
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
text | O Σ | 0..1 | string | Free text dosage instructions
Obligations | Actor
SHALL:handle | HDRConsumer
SHOULD:able-to-populate | HDRCreator
timing | O Σ | 0..1 | Timing | Administration schedule
Obligations | Actor
SHALL:handle | HDRConsumer
SHOULD:able-to-populate | HDRCreator
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
dispenseRequest | O | 0..1 | BackboneElement | Medication supply authorization
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
Slices for extension |  |  |  | Content/Rules for all slices
extension:prescribedQuantity |  | 0..1 | Quantity | Overall amount of product prescribed, independent from the number of repeats. URL: https://profiles.ihe.net/PHARM/MPD/StructureDefinition/ihe-ext-medicationrequest-prescribedQuantity
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
quantity | O | 0..1 | SimpleQuantity(4.0.1) | Amount of medication to supply per dispense
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.status | Base | required | Medicationrequest status | 📍4.0.1 | FHIR Std.
MedicationRequest.intent | Base | required | Medication request intent | 📍4.0.1 | FHIR Std.
MedicationRequest.medication[x] | Base | example | SNOMED CT Medication Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.reasonCode | Base | example | Condition/Problem/Diagnosis Codes | 📍4.0.1 | FHIR Std.

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | MedicationRequest.extension:effectiveDosePeriod, MedicationRequest.modifierExtension, MedicationRequest.dosageInstruction.modifierExtension, MedicationRequest.dosageInstruction.timing.modifierExtension, MedicationRequest.dispenseRequest.extension:prescribedQuantity, MedicationRequest.dispenseRequest.modifierExtension | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`

Differential View

This structure is derived from MedicationRequestEuHdr

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequestEuHdr | Ordering of medication for patient or group
status | O | 1..1 | code | Current state of the order
Obligations | Actor
SHALL:handle | HDRConsumer
SHOULD:able-to-populate | HDRCreator
medication[x] | O | 1..1 | CodeableConcept, Reference(Medication (HDR)) | Medication to be taken
Obligations | Actor
SHALL:handle | HDRConsumer
SHOULD:able-to-populate | HDRCreator
subject | O | 1..1 | Reference(Patient (EU core)) | Who or group medication request is for
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
authoredOn | O | 1..1 | dateTime | When request was initially authored
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
requester | O | 1..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) | Who/What requested the Request
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
reasonCode | O | 0..* | CodeableConcept | Reason or indication for this prescription
Obligations | Actor
SHALL:handle | HDRConsumer
MAY:able-to-populate | HDRCreator
reasonReference | O | 0..* | Reference(Condition | Observation) | Condition or observation that supports this prescription
Obligations | Actor
SHALL:handle | HDRConsumer
MAY:able-to-populate | HDRCreator
groupIdentifier | O | 0..1 | Identifier | Prescription this is part of. Not needed if a presciption includes only one prescribed item.
Obligations | Actor
SHALL:handle | HDRConsumer
MAY:able-to-populate | HDRCreator
dosageInstruction | O | 0..* | Dosage | How the medication should be taken.
Obligations | Actor
SHALL:handle | HDRConsumer
MAY:able-to-populate | HDRCreator
text | O | 0..1 | string | Free text dosage instructions
Obligations | Actor
SHALL:handle | HDRConsumer
SHOULD:able-to-populate | HDRCreator
timing | O | 0..1 | Timing | Administration schedule
Obligations | Actor
SHALL:handle | HDRConsumer
SHOULD:able-to-populate | HDRCreator
doseAndRate |  |  |  |
Slices for dose[x] |  |  |  | Content/Rules for all slices
dose[x]:doseQuantity | O | 0..1 | SimpleQuantity | Amount of medication per dose
Obligations | Actor
SHALL:handle | HDRConsumer
SHOULD:able-to-populate | HDRCreator
dispenseRequest | O | 0..1 | BackboneElement | Medication supply authorization
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
quantity | O | 0..1 | SimpleQuantity(4.0.1) | Amount of medication to supply per dispense
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
substitution |  |  |  |
Slices for allowed[x] |  | 1..1 | boolean, CodeableConcept | Whether substitution is allowed or not Slice: Unordered, Open by type:$this
allowed[x]:allowedCodeableConcept | O | 0..1 | CodeableConcept | Whether substitution is allowed or not
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
Documentation for this format

Snapshot View

Name | Flags | Card. | Type | Description & Constraints Filter: Bindings Constraints Obligations
--- | --- | --- | --- | ---
MedicationRequest |  | 0..* | MedicationRequestEuHdr | Ordering of medication for patient or group
id | Σ | 0..1 | id | Logical id of this artifact
meta | Σ | 0..1 | Meta | Metadata about the resource
implicitRules | ?!Σ | 0..1 | uri | A set of rules under which this content was created
language |  | 0..1 | code | Language of the resource content Binding: CommonLanguages (preferred): A human language.
Additional Bindings | Purpose
AllLanguages | Max Binding
text |  | 0..1 | Narrative | Text summary of the resource, for human interpretation This profile does not constrain the narrative in regard to content, language, or traceability to data elements
contained |  | 0..* | Resource | Contained, inline Resources
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:effectiveDosePeriod |  | 0..1 | Period | Period over which the medication should be taken. URL: http://hl7.org/fhir/5.0/StructureDefinition/extension-MedicationRequest.effectiveDosePeriod Constraints: ext-1
modifierExtension | ?! | 0..* | Extension | Extensions that cannot be ignored
identifier |  | 0..* | Identifier | Prescription/prescribed item ID
status | ?!O Σ | 1..1 | code | Current state of the order Binding: medicationrequest Status (required): A coded concept specifying the state of the prescribing event. Describes the lifecycle of the prescription.
Obligations | Actor
SHALL:handle | HDRConsumer
SHOULD:able-to-populate | HDRCreator
statusReason |  | 0..1 | CodeableConcept | Reason for current status Binding: medicationRequest Status Reason Codes (example): Identifies the reasons for a given status.
intent | ?!Σ | 1..1 | code | proposal | plan | order | original-order | reflex-order | filler-order | instance-order | option Binding: medicationRequest Intent (required): The kind of medication order.
category |  | 0..* | CodeableConcept | Type of medication usage Binding: medicationRequest Category Codes (example): A coded concept identifying the category of medication request. For example, where the medication is to be consumed or administered, or the type of medication treatment.
priority | Σ | 0..1 | code | routine | urgent | asap | stat Binding: RequestPriority (required): Identifies the level of importance to be assigned to actioning the request.
doNotPerform | ?!Σ | 0..1 | boolean | True if request is prohibiting action
reported[x] | Σ | 0..1 |  | Reported rather than primary record
reportedBoolean |  |  | boolean |
reportedReference |  |  | Reference(Patient | Practitioner | PractitionerRole | RelatedPerson | Organization) |
medication[x] | O Σ | 1..1 |  | Medication to be taken Binding: SNOMEDCTMedicationCodes (example): A coded concept identifying substance or product that can be ordered.
Obligations | Actor
SHALL:handle | HDRConsumer
SHOULD:able-to-populate | HDRCreator
medicationCodeableConcept |  |  | CodeableConcept |
medicationReference |  |  | Reference(Medication (HDR)) |
subject | O Σ | 1..1 | Reference(Patient (EU core)) | Who or group medication request is for
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
encounter |  | 0..1 | Reference(Encounter) | Encounter created as part of encounter/admission/stay
supportingInformation |  | 0..* | Reference(Resource) | Information to support ordering of the medication
authoredOn | O Σ | 1..1 | dateTime | When request was initially authored
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
requester | O Σ | 1..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | RelatedPerson | Device) | Who/What requested the Request
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
performer |  | 0..1 | Reference(Practitioner | PractitionerRole | Organization | Patient | Device | RelatedPerson | CareTeam) | Intended performer of administration
performerType | Σ | 0..1 | CodeableConcept | Desired kind of performer of the medication administration Binding: ProcedurePerformerRoleCodes (example): Identifies the type of individual that is desired to administer the medication.
recorder |  | 0..1 | Reference(Practitioner | PractitionerRole) | Person who entered the request
reasonCode | O | 0..* | CodeableConcept | Reason or indication for this prescription Binding: Condition/Problem/DiagnosisCodes (example): A coded concept indicating why the medication was ordered.
Obligations | Actor
SHALL:handle | HDRConsumer
MAY:able-to-populate | HDRCreator
reasonReference | O | 0..* | Reference(Condition | Observation) | Condition or observation that supports this prescription
Obligations | Actor
SHALL:handle | HDRConsumer
MAY:able-to-populate | HDRCreator
instantiatesCanonical | Σ | 0..* | canonical() | Instantiates FHIR protocol or definition
instantiatesUri | Σ | 0..* | uri | Instantiates external protocol or definition
basedOn | Σ | 0..* | Reference(CarePlan | MedicationRequest | ServiceRequest | ImmunizationRecommendation) | What request fulfills
groupIdentifier | O Σ | 0..1 | Identifier | Prescription this is part of. Not needed if a presciption includes only one prescribed item.
Obligations | Actor
SHALL:handle | HDRConsumer
MAY:able-to-populate | HDRCreator
courseOfTherapyType |  | 0..1 | CodeableConcept | Overall pattern of medication administration Binding: medicationRequest Course of Therapy Codes (example): Identifies the overall pattern of medication administratio.
insurance |  | 0..* | Reference(Coverage | ClaimResponse) | Associated insurance coverage
note |  | 0..* | Annotation | Information about the prescription
dosageInstruction | O | 0..* | Dosage | How the medication should be taken.
Obligations | Actor
SHALL:handle | HDRConsumer
MAY:able-to-populate | HDRCreator
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
sequence | Σ | 0..1 | integer | The order of the dosage instructions
text | O Σ | 0..1 | string | Free text dosage instructions
Obligations | Actor
SHALL:handle | HDRConsumer
SHOULD:able-to-populate | HDRCreator
additionalInstruction | Σ | 0..* | CodeableConcept | Supplemental instruction or warnings to the patient - e.g. "with meals", "may cause drowsiness" Binding: SNOMEDCTAdditionalDosageInstructions (example): A coded concept identifying additional instructions such as "take with water" or "avoid operating heavy machinery".
patientInstruction | Σ | 0..1 | string | Patient or consumer oriented instructions
timing | O Σ | 0..1 | Timing | Administration schedule
Obligations | Actor
SHALL:handle | HDRConsumer
SHOULD:able-to-populate | HDRCreator
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
event | Σ | 0..* | dateTime | When the event occurs
repeat | Σ C | 0..1 | Element | When the event is to occur Constraints: tim-1, tim-2, tim-4, tim-5, tim-6, tim-7, tim-8, tim-9, tim-10
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
bounds[x] | Σ | 0..1 |  | Length/Range of lengths, or (Start and/or end) limits
boundsDuration |  |  | Duration |
boundsRange |  |  | Range |
boundsPeriod |  |  | Period |
count | Σ | 0..1 | positiveInt | Number of times to repeat
countMax | Σ | 0..1 | positiveInt | Maximum number of times to repeat
duration | Σ | 0..1 | decimal | Duration of the treatment
durationMax | Σ | 0..1 | decimal | How long when it happens (Max)
durationUnit | Σ | 0..1 | code | s | min | h | d | wk | mo | a - unit of time (UCUM) Binding: UnitsOfTime (required): A unit of time (units from UCUM).
frequency | Σ | 0..1 | positiveInt | Frequency times per period
frequencyMax | Σ | 0..1 | positiveInt | Event occurs up to frequencyMax times per period
period | Σ | 0..1 | decimal | Duration of time over which repetitions are to occur
periodMax | Σ | 0..1 | decimal | Upper limit of period (3-4 hours)
periodUnit | Σ | 0..1 | code | Unit of the period (e.g. day) Binding: UnitsOfTime (required): A unit of time (units from UCUM).
dayOfWeek | Σ | 0..* | code | mon | tue | wed | thu | fri | sat | sun Binding: DaysOfWeek (required)
timeOfDay | Σ | 0..* | time | Time of day for action
when | Σ | 0..* | code | Code for time period of occurrence Binding: EventTiming (required): Real world event relating to the schedule.
offset | Σ | 0..1 | unsignedInt | Minutes from event (before or after)
code | Σ | 0..1 | CodeableConcept | A code for the timing schedule. Binding: TimingAbbreviation (preferred): Code for a known / defined timing pattern.
asNeeded[x] | Σ | 0..1 |  | Take "as needed" (for x) Binding: SNOMEDCTMedicationAsNeededReasonCodes (example): A coded concept identifying the precondition that should be met or evaluated prior to consuming or administering a medication dose. For example "pain", "30 minutes prior to sexual intercourse", "on flare-up" etc.
asNeededBoolean |  |  | boolean |
asNeededCodeableConcept |  |  | CodeableConcept |
site | Σ | 0..1 | CodeableConcept | Body site to administer to Binding: SNOMEDCTAnatomicalStructureForAdministrationSiteCodes (example): A coded concept describing the site location the medicine enters into or onto the body.
route | Σ | 0..1 | CodeableConcept | Route of administration Binding: SNOMEDCTRouteCodes (example): A coded concept describing the route or physiological path of administration of a therapeutic agent into or onto the body of a subject.
method | Σ | 0..1 | CodeableConcept | Technique for administering medication Binding: SNOMEDCTAdministrationMethodCodes (example): A coded concept describing the technique by which the medicine is administered.
doseAndRate | Σ | 0..* | Element | Amount of medication administered
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations Slice: Unordered, Open by value:url
type | Σ | 0..1 | CodeableConcept | The kind of dose or rate specified Binding: DoseAndRateType (example): The kind of dose or rate specified.
Slices for dose[x] | Σ | 0..1 |  | Amount of medication per dose Slice: Unordered, Closed by type:$this
doseRange |  |  | Range |
doseQuantity |  |  | Quantity(SimpleQuantity) |
dose[x]:doseQuantity | O Σ | 0..1 | SimpleQuantity | Amount of medication per dose
Obligations | Actor
SHALL:handle | HDRConsumer
SHOULD:able-to-populate | HDRCreator
rate[x] | Σ | 0..1 |  | Amount of medication per unit of time
rateRatio |  |  | Ratio |
rateRange |  |  | Range |
rateQuantity |  |  | Quantity(SimpleQuantity) |
maxDosePerPeriod | Σ | 0..1 | Ratio | Upper limit on medication per unit of time
maxDosePerAdministration | Σ | 0..1 | SimpleQuantity(4.0.1) | Upper limit on medication per administration
maxDosePerLifetime | Σ | 0..1 | SimpleQuantity(4.0.1) | Upper limit on medication per lifetime of the patient
dispenseRequest | O | 0..1 | BackboneElement | Medication supply authorization
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
id |  | 0..1 | string | Unique id for inter-element referencing
Slices for extension |  | 0..* | Extension | Extension Slice: Unordered, Open by value:url
extension:prescribedQuantity |  | 0..1 | Quantity | Overall amount of product prescribed, independent from the number of repeats. URL: https://profiles.ihe.net/PHARM/MPD/StructureDefinition/ihe-ext-medicationrequest-prescribedQuantity
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
initialFill |  | 0..1 | BackboneElement | First fill details
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
quantity |  | 0..1 | SimpleQuantity(4.0.1) | First fill quantity
duration |  | 0..1 | Duration | First fill duration
dispenseInterval |  | 0..1 | Duration | Minimum period of time between dispenses
validityPeriod |  | 0..1 | Period | Time period supply is authorized for
numberOfRepeatsAllowed |  | 0..1 | unsignedInt | Number of refills authorized
quantity | O | 0..1 | SimpleQuantity(4.0.1) | Amount of medication to supply per dispense
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
expectedSupplyDuration |  | 0..1 | Duration | Number of days supply per dispense
performer |  | 0..1 | Reference(Organization) | Intended dispenser
substitution |  | 0..1 | BackboneElement | Any restrictions on medication substitution
id |  | 0..1 | string | Unique id for inter-element referencing
extension |  | 0..* | Extension | Additional content defined by implementations
modifierExtension | ?!Σ | 0..* | Extension | Extensions that cannot be ignored even if unrecognized
Slices for allowed[x] |  | 1..1 |  | Whether substitution is allowed or not Slice: Unordered, Open by type:$this Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
allowedBoolean |  |  | boolean |
allowedCodeableConcept |  |  | CodeableConcept |
allowed[x]:allowedCodeableConcept | O | 0..1 | CodeableConcept | Whether substitution is allowed or not Binding: ActSubstanceAdminSubstitutionCode (example): Identifies the type of substitution allowed.
Obligations | Actor
SHALL:handle | HDRConsumer
SHALL:able-to-populate | HDRCreator
reason |  | 0..1 | CodeableConcept | Why should (not) substitution be made Binding: SubstanceAdminSubstitutionReason (example): A coded concept describing the reason that a different medication should (or should not) be substituted from what was prescribed.
priorPrescription |  | 0..1 | Reference(MedicationRequest) | An order/prescription that is being replaced
detectedIssue |  | 0..* | Reference(DetectedIssue) | Clinical Issue with action
eventHistory |  | 0..* | Reference(Provenance) | A list of events of interest in the lifecycle
Documentation for this format

#### Terminology Bindings

Path | Status | Usage | ValueSet | Version | Source
MedicationRequest.language | Base | preferred | Common Languages | 📍4.0.1 | FHIR Std.
MedicationRequest.status | Base | required | Medicationrequest status | 📍4.0.1 | FHIR Std.
MedicationRequest.statusReason | Base | example | Medication request status reason codes | 📍4.0.1 | FHIR Std.
MedicationRequest.intent | Base | required | Medication request intent | 📍4.0.1 | FHIR Std.
MedicationRequest.category | Base | example | Medication request category codes | 📍4.0.1 | FHIR Std.
MedicationRequest.priority | Base | required | Request priority | 📍4.0.1 | FHIR Std.
MedicationRequest.medication[x] | Base | example | SNOMED CT Medication Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.performerType | Base | example | Procedure Performer Role Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.reasonCode | Base | example | Condition/Problem/Diagnosis Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.courseOfTherapyType | Base | example | Medication request course of therapy codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​additionalInstruction | Base | example | SNOMED CT Additional Dosage Instructions | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​timing.repeat.durationUnit | Base | required | UnitsOfTime | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​timing.repeat.periodUnit | Base | required | UnitsOfTime | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​timing.repeat.dayOfWeek | Base | required | DaysOfWeek | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​timing.repeat.when | Base | required | EventTiming | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​timing.code | Base | preferred | TimingAbbreviation | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​asNeeded[x] | Base | example | SNOMED CT Medication As Needed Reason Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​site | Base | example | SNOMED CT Anatomical Structure for Administration Site Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​route | Base | example | SNOMED CT Route Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​method | Base | example | SNOMED CT Administration Method Codes | 📍4.0.1 | FHIR Std.
MedicationRequest.dosageInstruction.​doseAndRate.type | Base | example | DoseAndRateType | 📍4.0.1 | FHIR Std.
MedicationRequest.substitution.​allowed[x] | Base | example | ActSubstanceAdminSubstitutionCode | 📦3.0.0 | THO v7.1
MedicationRequest.substitution.​allowed[x]:allowedCodeableConcept | Base | example | ActSubstanceAdminSubstitutionCode | 📦3.0.0 | THO v7.1
MedicationRequest.substitution.​reason | Base | example | SubstanceAdminSubstitutionReason | 📦3.0.0 | THO v7.1

#### Constraints

Id | Grade | Path(s) | Description | Expression
dom-2 | error | MedicationRequest | If the resource is contained in another resource, it SHALL NOT contain nested Resources | `contained.contained.empty()`
dom-3 | error | MedicationRequest | If the resource is contained in another resource, it SHALL be referred to from elsewhere in the resource or SHALL refer to the containing resource | `contained.where((('#'+id in (%resource.descendants().reference | %resource.descendants().as(canonical) | %resource.descendants().as(uri) | %resource.descendants().as(url))) or descendants().where(reference = '#').exists() or descendants().where(as(canonical) = '#').exists() or descendants().where(as(canonical) = '#').exists()).not()).trace('unmatched', id).empty()`
dom-4 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a meta.versionId or a meta.lastUpdated | `contained.meta.versionId.empty() and contained.meta.lastUpdated.empty()`
dom-5 | error | MedicationRequest | If a resource is contained in another resource, it SHALL NOT have a security label | `contained.meta.security.empty()`
dom-6 | best practice | MedicationRequest | A resource should have narrative for robust management | `text.`div`.exists()`
ele-1 | error | **ALL** elements | All FHIR elements must have a @value or children | `hasValue() or (children().count() > id.count())`
ext-1 | error | **ALL** extensions | Must have either extensions or value[x], not both | `extension.exists() != value.exists()`
tim-1 | error | MedicationRequest.dosageInstruction.timing.repeat | if there's a duration, there needs to be duration units | `duration.empty() or durationUnit.exists()`
tim-2 | error | MedicationRequest.dosageInstruction.timing.repeat | if there's a period, there needs to be period units | `period.empty() or periodUnit.exists()`
tim-4 | error | MedicationRequest.dosageInstruction.timing.repeat | duration SHALL be a non-negative value | `duration.exists() implies duration >= 0`
tim-5 | error | MedicationRequest.dosageInstruction.timing.repeat | period SHALL be a non-negative value | `period.exists() implies period >= 0`
tim-6 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a periodMax, there must be a period | `periodMax.empty() or period.exists()`
tim-7 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a durationMax, there must be a duration | `durationMax.empty() or duration.exists()`
tim-8 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a countMax, there must be a count | `countMax.empty() or count.exists()`
tim-9 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's an offset, there must be a when (and not C, CM, CD, CV) | `offset.empty() or (when.exists() and ((when in ('C' | 'CM' | 'CD' | 'CV')).not()))`
tim-10 | error | MedicationRequest.dosageInstruction.timing.repeat | If there's a timeOfDay, there cannot be a when, or vice versa | `timeOfDay.empty() or when.empty()`

This structure is derived from MedicationRequestEuHdr

Summary

Structures

This structure refers to these other structures:

- SimpleQuantity (http://hl7.org/fhir/StructureDefinition/SimpleQuantity)

Slices

This structure defines the following Slices:

- The element 1 is sliced based on the value of MedicationRequest.substitution.allowed[x]

Maturity: 0

Other representations of profile: CSV, Excel, Schematron